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The Aesthetic Surgery Education and Research Foundation

Award Winners and Funded Projects
Systemic Symptoms: Biospecimen Analysis Study Print

The ASERF Scientific Research Committee and Board of Directors are pleased to announce the following grant award:

Researcher: Patricia McGuire, MD & Caroline Glicksman, MD

Grant Award: ASERF Interim Grant

Amount Awarded: $221,925.00

Project Name: Systemic Symptoms: Biospecimen Analysis Study

Project Summary:

Although it is accepted that there is an association between textured breast implants and Anaplastic Large Cell Lymphoma, there is no current definitive epidemiologic evidence to support a direct link between breast implants and any autoimmune disorders at this time.  However, there are an increasing number of women who are pursuing an explantation because of what is being referred to as “breast implant illness” ("BII"), a term originating from a social media group used to describe a collection of nonspecific systemic symptoms thought to be caused by breast implants.  As of 2018, there were over 80,000 women on the two main Facebook sites, Breast Implant Illness and Healing and Breast Implant Victim Advocacy. Reported symptoms include but are not limited to fatigue, chest pain, hair loss, headaches, arthralgias, allergies, easy bruising, heartburn, decreased sex drive, gastrointestinal upset, heart palpitations, hot flashes, infections, night sweats, heat/cold intolerance, migraines, anxiety, swelling, tinnitus, weight gain, chronic muscle/joint pain, rash, body odor, brain fog, sleep disturbance, depression, cognitive dysfunction, hormone imbalances, dry eyes and skin changes.  In the majority of patients, objective markers, such as serologic abnormalities are absent.  There is no established pathophysiologic explanation or diagnostic test for "breast implant illness"; it is not a recognized medical disease at this time.

Recently, several new studies have been designed and funded to better understand the possible role of psychological and social behavioral factors that may be concomitant in women who are reporting symptoms of "BII." This study, in contrast, has been designed to scientifically analyze biospecimens from three groups: Group 1 -  women with breast implants who are presenting with "BII" and pursuing explantation; Group 2 - women with breast implants who are not presenting with "BII" and are undergoing explantation for other reasons (weight gain, or elective explantation with mastopexy); and Group 3: an age matched control group of women undergoing an elective mastopexy without previous exposure to breast implants.

 
Pilot study to identify a genetic predisposition to BIA-ALCL Print

The ASERF Scientific Research Committee and Board of Directors are pleased to announce the following grant award:

Researcher: Terence Myckatyn, MD

Grant Award: ASERF Interim Grant

Amount Awarded: $24,736.00

Project Name: Pilot study to identify a genetic predisposition to BIA-ALCL

Project Summary:

Specific Goal. To characterize somatic and germline mutations in a cohort of women who received en bloc capsulectomies for breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) using whole exome sequencing (WES) and whole genome sequencing (WGS) approaches. Importantly, we already have tissue and blood for all the BIA-ALCL patients we propose to study in this proposal. These specimens are available for immediate analysis. We can have data in less than 6 months from initiation of funding.

Hypothesis. WGS of the capsulectomies containing BIA-ALCL and matched normals will identify genetic alterations that help better understand the somatic and germline drivers of this disease.  

 
Understanding Breast Implant Illness Print

The ASERF Scientific Research Committee and Board of Directors are pleased to announce the following grant award:

Researcher: Jill Newby, PhD

Grant Award: ASERF Interim Grant

Amount Awarded: $20,000.00

Project Name: Understanding Breast Implant Illness

Project Summary:

Breast implant illness (BII) is a new term used to describe a myriad of symptoms that are proposed to be caused by breast implant (Magnusson et al. 2019); however, to date no scientific information has confirmed this, and there is no diagnostic test to make the diagnosis.
The ultimate goal of this project is to better understand the nature and causes of Breast Implant Illness, so that it can be: prevented (in women without symptoms), or treated and cured (in women with symptoms).
This project also aims to better understand the role of psychological/behavioral factors in perpetuating the distress linked to unexplained symptoms after implant surgery.

 
Defining Ideal Female Genital Anatomy Through Novel Crowdsourcing Analysis Print

The ASERF Scientific Research Committee and Board of Directors are pleased to announce the following grant award:

Researcher: Herluf Lund, MD & Alexander Lin, MD (Co-PIs)

Grant Award: ASERF Interim Grant

Amount Awarded: $16250.00

Project Name: Defining Ideal Female Genital Anatomy Through Novel Crowdsourcing Analysis

Project Summary:

Labiaplasty continues to increase in popularity in the United States with 10,787 surgical and non-surgical labiaplasty procedures performed in 2017. The American Society for Aesthetic Plastic Surgery (ASAPS) reports a 217.3% increase in labiaplasty procedures performed in the United States from 2012 to 2017.  The increased demand for labiaplasty is multifactorial and has been attributed to exposure through television and internet, the growing popularity of shaving the genital area, and increased media attention (Koning et al). Female genitalia displayed in the media is rarely asymmetric and frequently undergoes retouching, thus creating an unrealistic standard to which females compare their own anatomy and creating increased self consciousness in women regarding their genitalia. This has contributed to increased demand of labiaplasty procedures, as these procedures are most often pursued by women who are unsatisfied with the appearance of their genitalia or believe it is abnormal (Laan et al.). Although multiple studies have published ranges of quantitative measurements to define the normal external female genitalia (Gunthert et al., Lloyd et al.), no studies describe ideal female genital anatomy. As with many other procedures in plastic surgery, the goal of labiaplasty is not only a normal result, but an aesthetically ideal one.

In our proposed study we hope to establish ideal anatomic norms for female genitalia through crowdsourcing and identify any differences in ideal female genital anatomy that may exist between demographic groups in order to guide labiaplasty procedure aesthetic outcomes. Crowdsourcing is a novel technology utilizing large number of laypeople via the internet (“wisdom of the crowds”) whose aggregate results are valid in multiple types of studies (Crump et al.), but has not been applied to female genital anatomy.

 
Academic Aesthetic Surgery Census and Consensus Conference Print

The ASERF Scientific Research Committee and Board of Directors are pleased to announce the following grant award:

Researcher: Galen Perdikis, MD and Felmont Eaves, III, MD (CO-PIs)

Grant Award: ASERF Interim Grant

Amount Awarded: $25,500

Project Name:
Academic Aesthetic Surgery Census and Consensus Conference

Project Summary: 

Hypothesis: There are significant challenges and opportunities for aesthetic surgery within academic institutions which are often more focused on and conducive to reconstructive practices.  However the development of successful academic aesthetic surgery practices and educational capabilities are key to promoting faculty practice development, departmental/division financial stability, research in aesthetic surgery, and comprehensive resident and fellow education.  By developing a clear understanding of the current state of aesthetic aesthetic surgery and developing strategies to address the challenges of aesthetic surgery within academic centers the specialty as a whole can be strengthened.

Goals:    1. Perform a comprehensive audit of the current state of aesthetic surgery at academic institutions.  The audit will identify common obstacles and strengths, financial implications (compensation, department/division net impact), faculty capabilities and aesthetic practice development (performance evaluation, promotion), aesthetic research capabilities, and aesthetic education (aesthetic topics, resident aesthetic case exposure/participation, resident aesthetic clinics, etc.)  (Draft:  See attachment A).
               2. Round table in person meeting to analyze audit findings and formulate best practices and strategies in the format of a consensus statement.
               3. Dissemination of best practices to all Academic Centers through ASAPS, ACAPS, & AAPS
               4. Assess impact and changes successfully made based on recommendations by re-assessment (repeat audit in 2-3 years).

Relevance:    Aesthetic surgery is one of the pillars of our specialty and is of paramount importance to our financial viability as departments and divisions in the future. We need to be able to provide state of the art training in aesthetic surgery to remain the ultimate standard bearers of quality and outcomes in aesthetic surgery. The practice of aesthetic surgery at academic institutions and the capabilities, functionality, and institutional support thereof is widely variable. The reasons for this are not fully understood and have not been studied adequately. By studying underlying barriers and opportunities and by bringing together leaders to develop consensus on successful strategies and tactics to build and promote aesthetic surgery we hope to help academic aesthetic centers demonstrate relevance to their institutions and garner critical support. Over the long term the group intends to make participation available to all academic programs involved in residency training and to explore ways to expand aesthetic surgery related research, an attractive option considering the research capacity and experience housed in academic centers.

 
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